We present a rare case of a single coronary artery originating from the right sinus of Valsalva. The incidence of this anomaly is 0.004%.
Case Description
A 65-year-old woman with diabetes mellitus and dyslipidemia presented for evaluation of chest tightness and dyspnea on minimal exertion. The results of a stress test performed when she was 49 years old were normal. Cardiac catheterization revealed a left ventricular ejection fraction of 60%, without wall motion abnormalities. There was difficulty identifying a left coronary ostium. The injection of contrast material into the right coronary artery revealed a single coronary artery free of any narrowing. Computed tomographic coronary angiography ( Figure 1 ) demonstrated that the right coronary artery itself was dominant and gave rise to the posterior circulation. The left anterior descending coronary artery took a course anterior to the pulmonary trunk and supplied the anterior wall of the left ventricle. The left circumflex coronary artery had a retroaortic course and gave rise to the anterior-lateral and lateral territories, including diagonal branches.
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